Methanol Poisoning in Uganda: Symptoms, Treatment and Prevention

What is Methanol Poisoning?

Methanol is a chemical found in some industrial solvents and methylated spirits. Sometimes it is swallowed intentionally for self-harm or mistakenly consumed as a substitute for alcoholic drinks, especially in home-distilled alcohol where methanol may not be fully removed. A dose above 1 gram per kilogram of body weight can be deadly. Methanol breaks down in the body into toxic substances that cause severe acid build-up and damage to the eyes and nerves.

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Symptoms

  • Initial drunkenness similar to regular alcohol
  • A silent period without symptoms lasting 12 to 24 hours
  • Headache, dizziness, nausea, vomiting
  • Vision problems, central nervous system depression, breathing failure
  • Severe acidosis and damage to the retina and optic nerves

Treatment

  • Gastric aspiration and lavage may be performed, but only if within 2 hours of ingestion, since methanol is absorbed quickly.
  • Activated charcoal is not effective and should not be used.
  • Oral alcohol (40%, such as waragi, whisky, or brandy) is given as an antidote: a loading dose of 1.5 to 2 ml per kilogram in 180 ml of water, given either by mouth or through a nasogastric tube.
  • Maintenance dose of oral alcohol is 0.3 ml per kilogram per hour.
  • Sodium bicarbonate 50-100 ml is given intravenously over 30 to 45 minutes to correct acidosis.
  • Blood sugar is checked and corrected if low (hypoglycaemia).
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